Donepezil, rivastigmine, galantamine and memantine for ...

If drug therapy stabilised some of the symptoms
of AD for even a limited period of time, the
QoL of patients and carers may be affected. Carers
of people with AD are often family members and
are often elderly themselves. Any improvement in
symptoms that leads to greater independence of
the person with AD may reduce some of the
physical and emotional responsibilities for the
carer. If drug therapy was effective in delaying
institutionalisation, this would have an impact on
patients, their carers and other parties. In
particular, there would be continued need for
further support from the wide range of agencies
which currently supply services for patients and
their carers in the community.
The sparse literature on the costs associated with
AD reports that a significant proportion of the cost
of caring for AD falls on patients and caregivers. A
review of nine studies on costs for community-
Chapter 8
Implications for other parties
© Queen’s Printer and Controller of HMSO 2006. All rights reserved.
Health Technology Assessment 2006; Vol. 10: No. 1
based people with AD estimated that the
proportion of total costs represented by informal
care ranges between 36 and 85%. 188 This wide
range is in part due to differences in the type of
costs included and the methods used to quantify
and value caregiver time. O’Shea and O’Reilly, 152
in a cost study of AD in Ireland, report that family
care accounts for almost 50% of the overall
resource burden for AD (based on an opportunity
cost valuation of carer time). It is difficult to
estimate the impact on informal costs, and/or
caregiver time, from treatment with the
pharmaceuticals discussed in this review, owing to
the varied methodology and coverage of these
issues in published cost and cost-effectiveness
studies, but consideration should be given to the
significant inputs of time and resource by caregivers
to the treatment of AD and to the costs met
by AD patients themselves in the management of
this disease.
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